chatwithketch

Q: Hi doctor my problem is that I have  got a toothache and my teeth are decaying and making holes. I have removed five. I am still a young mum and now I can’t eat properly. Is there any way I can replace my removed teeth? It’s making me annoyed and uncomfortable when it comes eating time please!

A: Toothaches are mainly due to tooth decay, which may give rise to a hole in the tooth.

How does a tooth get to the point of a cavity/hole? There are bacteria that live naturally in the mouth. When we eat foods rich in sugar and starch, the bacteria act on these foods and produce acids. These acids can eat away at the enamel covering of teeth. If these foods are eaten often, serious damage can be done to the teeth leading to the formation of cavities and subsequent decay as the acid eats its way through the enamel and may even get to the nerve ending! Imagine the quantum of pain, this person will experience! If left untreated, this can lead to a dental abscess (like a boil in the area).

If you’ve ever had a tooth ache or been close to someone who’s had one, you don’t need to be told the symptoms 😀 It is sheer excruciating pain especially when cold, hot or sweet things are taken. There may also be visible holes in the teeth.

What to do? You need to see your dentist asap. In the meantime, gargle with warm water and take some analgesics. Remember not to go over the recommended dosage. Use dental floss to remove food debris in between teeth.

Treatment is focused on putting a filling on it, root canal treatments or crowns or dentures if there is complete loss of the tooth. Your doctor will advise.

To prevent this, be sure to remember and follow the rule of twos: brush your teeth twice a day, brush your teeth for at least 2 minutes (brushing up and down in circular motions) and see your dentist at least twice a year. Use fluoride-containing toothpaste. How do you find this? Walk into any shop or supermarket and read the ingredients on the pack. If it states that it has fluoride in it, you’re on the right path 😀 Limit your intake of sugary substances…make them occasional treats and if you do take them, please rinse out your mouth or better still, brush your teeth. Be sure to brush your teeth last thing before you go to bed. If you eat afterwards and take in sugary stuff, the acid produced really has time to eat away at your teeth while you’re sleeping as a result of the fact that less saliva is produced.

All the best!

Q: I found out that my body shakes always even when I am standing. Please, what’s the problem and solution?

A: There are a few causes of shaking or tremors as they are called medically. Tremors may be familial i.e. runs in families, with the shaking noticed more when stretching out the hands or carrying out an activity; In this case, there are usually no other problems associated with it.

Tremors could also be a sign of some abnormalities in the body’s functioning – endocrine abnormality. In this case, there is shaking (especially in the hands), fast racing heartbeat, which the individual can hear/feel, sleeping problems, excessive sweating and possibly a neck swelling.

Other causes include:

• Certain drugs
• Liver, kidney or long standing lung diseases
• Alcohol intoxication
• Withdrawal from hard drugs
• Parkinson’s disease (a disorder of certain substances in the brain)
• Anxiety or panic attacks (fear of places, situations or circumstances, which exceeds that which can ordinarily be explained)

Remember when you had to write an exam, which was all important to you and your parents, or present something in front of the class or assembly for the first time…shaky, weren’t you?

I may not be able to identify the cause of your symptoms, but I would advise you take some time off. Stress, if you are undergoing any form of it, (physical, emotional, or psychological) could also be the source of this problem. It’s time to sit back, identify the likely causes and address them from within you to the outward.

For those things/issues you cannot resolve immediately, remember the serenity prayer:

God grant me the serenity to accept the things I cannot change;

Courage to change the things I can;

And wisdom to know the difference

Exercise is also a good way to relax and relieve stress. But most importantly visit your doctor who would evaluate you, identify the possible cause of the shaking, and recommend appropriate treatment.

Hope this helps. Best wishes.

***** This post was contributed by a doctor guest blogger.

Have a great night, people 😀

Q: Please what is tampon?

A: Tampons are products like sanitary pads used to absorb menstrual flow. A tampon is cylindrical in shape and has a string at one end that can be used to pull the tampon out. Sometimes, this string may go inside your body but you can usually feel the tampon and pull it out.

There is a dangerous infection that can occur in females who use tampons. It’s called Toxic Shock Syndrome (TSS). It is not caused by tampons but because tampons in the vagina create a perfect environment for bacteria (staphylococcus aureus in this case) to thrive, a toxin is created that causes severe illness. Young teens with fewer antibodies to the infection are more likely to experience this than older females.

Symptoms of TSS include sudden high fever, headaches, redness of the eyes, mouth and throat, vomiting, diarrhea, seizures etc. If you experience any of these, while wearing a tampon, remove it immediately and contact your doctor.

Here are general rules for using tampons safely:

·      Be careful when inserting tampons. Remember that , Staphylococci, Staph for short, are bacteria which can be found in people’s noses or skin all over the body, minding their own business until a cut or injury occurs giving the germs access into the body. So, introducing an injury while inserting the tampon, increases the chances of TSS.

·      Keep your hands squeaky clean especially when changing tampons

·      Change your tampons every 4 to 6 hours

·      Do NOT let it stay inside you for more than 8 hours.

·      Do NOT use tampons to absorb any fluid other than your menstrual flow. Don’t use it as you would use a panty liner.

·      Alternate between tampons and sanitary pads eg tampons during the day and pads at night.

·      Ensure the tampon is removed very quickly if you observe any of the following:

·      Pelvic pain

·      High temperature

·      Unpleasant smell

·      Vaginal discharge

All the best!

Q: Hey I would like to know if putting bicarbonate of soda is dangerous on the vagina,as I used it to get rid of vaginal smell. It did help but it’s like my vagina shrank. I’ve never slept with a guy before so I am puzzled. Could I even lose my virginity over it I? I know it’s weird but my VJ is not the same anymore. Thanks in advance

A: What you were trying to do is called douching. But first let’s start with a statement of fact….Some degree of vaginal odour is common with all women. The vagina has a natural musky smell. In the same way, some degree of discharge is also normal as the glands in the vagina and cervix produce fluid which wash away dry, dead cells and flush out bacteria. A strong vaginal odour which appears different from normal especially when associated with other symptoms like a burning sensation, itching, discharge etc may be suggestive of a problem…some more easily solved than others.

For instance:
Poor vaginal hygiene. This can be easily remedied by washing the vagina daily with or without soap (if soap is used, unscented or mildly scented soap should be used) and loads of water, not douching, cleaning from the front to the back etc. Vaginal odour may also be more pronounced during a menstrual period and after sexual intercourse. And so, more frequent baths (as much as practicable) during and/or before these periods may be helpful. Frequent change of sanitary towels and tampons are also helpful measures. Forgotten tampons are actually a cause of vaginal odour.

A fishy smell associated with vaginal discharge is suggestive of overgrowth of the vagina by bacteria (bacterial vaginosis). This may be caused by over use of antibiotics or douching.

Douche is a French word which means to clean or soak. People who douche usually inject/spray a mixture of water and vinegar into their vagina. Other douches contain antiseptics and fragrance too. They believe that douching serves one or more of the following functions:

• Cleaning the vagina
• Cleaning out menstrual blood after a period
• Prevent pregnancy
• Prevent STIs
• Get rid of odour

Unfortunately, douching serves none of those purposes and indeed, may even be harmful as you may have noticed with your experience. I suggest that you go see a doctor to get checked out, if you think something is wrong.

To clean the vagina during or after a menstrual period, one does not really need anything other than water. Mild, unscented soap may also be used on the outside. Douching disturbs the natural balance between the good and bad bacteria which live in the vagina, causing other organisms like yeasts to over grow the vagina. So avoid this and other scented feminine hygiene products.

Douching does not prevent pregnancy as loads of sperm may have already swum up to the womb before douching is done, after sexual intercourse. In fact, for those that may not have reached the womb (uterus), the force of douching may very well help deposit the sperm firmly in the uterus 😀 Talk about a boomerang!

STIs cannot be prevented by douching. In fact, if anything, if there is a vaginal infection, douching can actually push it all the way up to the fallopian tubes, potentially. These may lead to pregnancy complications in baby, labor and indeed, preterm delivery.

In summary, leave douching well alone! 😀

Yellow or greenish or frothy discharge with a bad smell with pain and itching while urinating is suggestive of trichomoniasis infection (a sexually transmitted infection)

Some cancers like cervical or vaginal cancer may also cause vaginal odour.

What’s the remedy? Well, if it’s due to lack of vaginal hygiene, that’s easily solved as noted above. If there are other associated symptoms which may suggest other problems, than a proper diagnosis needs to be made so that adequate treatment can be given. So, see a doctor asap.

In the meantime, vaginal hygiene is a good place to start and then, incorporate the other tips noted above.

I hope this helps.

Have a good weekend, y’all

‘
Need another reason to monitor your intake of ultra-processed foods? Cutting down on your amounts could help you live longer. ‘ Read

https://www.health.harvard.edu/staying-healthy/eating-more-ultra-processed-foods-may-shorten-life-span

Q: Good Evening Doc, Pls am a bit worried. My daughter of a week and six days is having rashes on her vagina wall. I don’t know if is the diaper that caused it. Please assist on what to do.

A: Congratulations on your new baby and don’t worry, motherhood just looks/feels harder than it really is. In a few months now, you’ll be dispensing motherly advice to other new mums 😀

Diaper rashes are common in babies and they could happen on the butt or anywhere around the area including the lips of the vagina as you have observed. The causes include
• Prolonged contact with urine or stool
• Diapers that are too tight
• Harsh detergents, soaps
• Baby wipes.
• Sensitivity

Prevention essentially focuses on the causes. So,
• Change your baby’s diaper as soon as you realize it’s wet or soiled
• Be sure to buy the right size of diapers and avoid harsh soaps and detergents.
• Keep baby’s butt open to air dry as long as practicable 😀 I hear some of you mums groaning…I know, you’re taking a huge fat risk that he or she will do their business while you’re trying to air dry them 😀
• Ensure that baby’s butt is dry before closing up the diaper after a change
• Pat baby’s butt dry especially if he/she already has a diaper rash to prevent irritation
• Always have a diaper rash cream handy. Creams that contain zinc like Sudocrem or Desitin are good examples. I used the latter for my babies and it always worked like a charm.
Diaper rash that does not ‘sneak’ away after a couple of days (about a week) may be due to a yeast (candida) infection. And before you raise your eyebrows, yes this can in babies and may be due to yeast overgrowth in babies taking antibiotics or breastfeeding babies whose mothers are on antibiotics, poor hygiene when cleaning baby up after a poo (such that baby is cleaned from the back to the front), the moist and warm environment provided by unchanged diapers etc These rashes are usually well defined with raised borders.

If the rashes develop some pus like fluid, then this is the sign of a bacterial infection (impetigo) and needs to be treated with antibiotics.

So rule of thumb is change your baby often to prevent prolonged contact with poo or urine and keep the area clean. Use barrier (nappy rash cream) at the first sign of a rash and if this does not improve after a few days, she should be ideally seen by her doctor to confirm whether this is a fungal infection. Note that other rare causes of rashes are eczema, psoriasis etc

In the case above, I assume that you had used a barrier cream initially (or maybe not) before using the antifungal cream. Since the rashes are not getting any better, please take your baby to see her paediatrician.

For more on diaper-related issues, please click on the links below:
https://chatwithdrketch.com/2014/06/30/daily-health-tips-my-baby-is-having-a-reaction-to-her-diapers/
https://chatwithdrketch.com/2014/01/07/daily-health-tips-more-diaper-tips/
https://chatwithdrketch.com/2014/01/03/daily-health-tips-diaper-bag-essentials/
https://chatwithdrketch.com/2013/12/19/daily-health-tips-diapering-your-baby/

Have a good night, y’all 😀

Q: Good morning, Dr. Please is there any other way of getting rid of hernia on a female child except by surgery. Something like medication or injection. Thanks

A: Thanks for writing in. How old is this child?

A quick refresher class on herniae…

Hernia is the protrusion of an organ through a defect (like a hole or opening) in the wall of the muscle or cavity which usually holds it in place. There are different types hernias (or herniae) and they include:

Inguinal hernia: The most common type of hernia. It usually happens in situations where the pressure inside the abdomen is increased.

Other hernias include incisional hernia (where a protrusion develops from the site of a previous surgery, especially abdominal surgery), femoral hernia (which has the same risk factors as inguinal), umbilical hernia (common in black children where the umbilicus, aka navel does not form a small ‘button’ on the abdominal wall but protrudes) and hiatal hernia (where the stomach squeezes through a hole meant for the oesophagus (the pipe through which food gets to the stomach).

Typically, all hernias are caused by a weakness in the wall of muscles or containing cavities and an increase in pressure. Examples of activities that increase pressure in the abdomen are long-standing cough or frequent sneezing, carrying heavy loads regularly, straining at stool whether due to constipation or diarrhea etc. The walls of muscles are usually weakened in people who are obese, pregnant women, smokers and malnourished people. It is also more common in men and as people grow older.

What are the symptoms? People with hernia would usually notice a protrusion after a strain eg lifting something heavy or coughing. Sometimes, they are able to push it back. Other times they are not. The worry about hernia and the reason why they have to be treated quickly is that they may strangulate. Yes, just think about the word strangle and you understand what strangulate means J The protrusion may become squeezed by the opening through which it passes blocking off blood supply to the area protruding. Once a part of the body is deprived of blood, it dies. We don’t want that to happen!

The decision as to whether to go for surgery or not depends on where the hernia is located (inguinal and femoral hernias usually need surgery), the contents of the hernia sac and the symptoms. A truss (a supportive device that prevents enlargement of a hernia) may be prescribed by your doctor to help for a short period of time. Typically a doctor will schedule a surgery to repair a hernia. Complaints of pain in a hernia patient may mean strangulation, which need to be dealt with immediately. Umbilical hernia does not usually require surgery as the protrusions usually ‘return’ on their own. If this persists beyond 5 years, then surgery may be needed.

If you do require surgery, you don’t need to fret about it…really. This is not major surgery…it’s intermediate (sort of like half way between minor and major :D). Your doctor will provide answers to all the questions you have and of course, counseling. There are options for laparoscopic surgery which is surgery done through small incisions guided by a camera.

Preventive measures include having a healthy weight, giving up smoking, treating conditions that may lead to long-standing coughs, eating healthy to prevent straining at stool etc. These are the self-help options available to you now. I am worried though, about the possibility of strangulation. I suggest that you go to a Government hospital. Consultation fee will be moderate and a doctor will give you a proper diagnosis after examining you.

All the best!

Have a good evening, everyone 😀

Q: Hello doc. Good day. Please doctor can you talk about low thyroid in pregnancy and the causes and the remedy, please. God bless you Doc.

A: In hypothyroidism, the body does not produce enough of the thyroid hormones due to an underactive thyroid gland. The symptoms include tiredness, weight gain, constipation, increased sensitivity to cold, depression etc

Causes of hypothyroidism include autoimmune diseases (when the body turns on itself, producing antibodies that attack and destroy the thyroid gland), inadequate iodine in the diet, radiation therapy to the neck, thyroid surgery (in which some or all of the thyroid is removed) etc. Other factors associated with this condition include pregnancy, certain drugs etc Risk factors for hypothyroidism include white race, growing older, having prematurely graying hair etc.

The major issue causing the symptoms is the lack of thyroid hormones and so treatment is targeted at that. Synthetic thyroid hormones will be prescribed to help combat these. Effects on fatigue may be observed as early as two weeks after treatment is started.

So, please see your doctor for a proper examination and he/she will make a diagnosis after which a course of action will be determined.

Have a good night, everyone 😀

Q: Hello Dr. Thanks for the wonderful works you’re doing on social media. Please, in addition to breast milk, what can I give to my 3 months old son because my wife is finding it difficult to cope with her business

A: Congratulations on your new baby!

Breast milk is the best food for baby for the first six months, generally speaking. I’m a great advocate and will be telling you how your wife can make it work. The supply of breast milk is based on its demand. And so, if demand for it is high, supply will be high and vice versa. The more efficiently milk is removed from the breast, the more milk production is stimulated. And so, there needs to be a conscious effort to get baby to suck more.

If your baby sucks, the let-down reflex ensures that your wife’s breast fills up with breast milk. Flat nipples can appear to be a challenge for breast feeding, especially for first time mothers but remember that babies are supposed to latch on to the areola (the black area surrounding the nipples) and not on to the nipples. Your wife should try pressing on the areola with thumb on top and fingers underneath and push back against her chest wall while pressing in with her thumb and fingers. This helps elongate the areola and so, provided she positions the baby properly on the areola, breast feeding can go on with no issues.

Here are other tips that could help increase milk supply:

• Be sure that baby is attached properly and get him to suckle on the breast very often. Remember that breast milk production is a function of the breast milk let down reflex which is activated when baby sucks.
• If she can find a private space within her office/business space where she can express milk, encourage her to go for it.
• Let her increase the number of feeds per day. She could work with a timetable of a feed every 2 to 3 hours. In her case, as many times as is possible when she gets back from the office.
• She should switch breasts during a mealtime. Let the first breast ‘empty’ before switching baby to the other breast. This can be repeated several times during a feed.
• She should massage her breast and stroke towards the baby
• Perhaps over the weekend, let her room in with your baby and get him to feed as much as possible. The letdown reflex will be greatly stimulated and so, she could even pump some for when she will be at work and freeze.

Personally, I found that using my hands to ‘milk’ my breasts produced sufficient amounts of breast milk for my always-hungry-can’t-seem-to-get-enough-food-baby. She may want to try that.

Drugs and foods that encourage milk production are called galactogogues. A number of local foods have been touted to help eg Pap (akamu, ogi), green leafy veggies like spinach, oats, garlic and ginger, nuts like almonds etc Go ahead and try out what works for you.

I hope y’all had a great day!